Endoscopic reposable surgical clip applier

ABSTRACT

A surgical clip applier is provided and includes a handle assembly and an endoscopic assembly selectively connectable to a housing of the handle assembly. The handle assembly includes a housing, a trigger pivotally supported on and extending from the housing, and a drive assembly supported within the housing and operatively actuatable by the trigger. The endoscopic assembly includes a shaft assembly extending from the housing, the shaft assembly including an outer tube and a pair of jaws supported in and extending from a distal end of the outer tube.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application claims the benefit of and priority to U.S. ProvisionalPatent Application No. 62/130,724 filed Mar. 10, 2015, the entiredisclosure of which is incorporated by reference herein.

BACKGROUND

1. Technical Field

The present disclosure relates to surgical clip appliers. Moreparticularly, the present disclosure relates to endoscopic reposablesurgical clip appliers having a reusable handle assembly, a reusableshaft assembly, and a disposable clip cartridge assembly.

2. Description of Related Art

Endoscopic staplers and clip appliers are known in the art and are usedfor a number of distinct and useful surgical procedures. In the case ofa laparoscopic surgical procedure, access to the interior of an abdomenis achieved through narrow tubes or cannulas inserted through a smallentrance incision in the skin. Minimally invasive procedures performedelsewhere in the body are often generally referred to as endoscopicprocedures. Typically, a tube or cannula device is extended into thepatient's body through the entrance incision to provide an access port.The port allows the surgeon to insert a number of different surgicalinstruments therethrough using a trocar and for performing surgicalprocedures far removed from the incision.

During a majority of these procedures, the surgeon must often terminatethe flow of blood or another fluid through one or more vessels. Thesurgeon will often apply a surgical clip to a blood vessel or anotherduct to prevent the flow of body fluids therethrough during theprocedure. An endoscopic clip applier is known in the art for applying asingle clip during an entry to the body cavity. Such clips are typicallyfabricated from a biocompatible material and are usually compressed overa vessel. Once applied to the vessel, the compressed clip terminates theflow of fluid therethrough.

Endoscopic clip appliers that are able to apply multiple clips inendoscopic or laparoscopic procedures during a single entry into thebody cavity are described in commonly-assigned U.S. Pat. Nos. 5,084,057and 5,100,420 to Green et al., which are both incorporated by referencein their entirety. Another multiple endoscopic clip applier is disclosedin commonly-assigned U.S. Pat. No. 5,607,436 by Pratt et al., thecontents of which is also hereby incorporated by reference herein in itsentirety. These devices are typically, though not necessarily, usedduring a single surgical procedure. U.S. Pat. No. 5,695,502 to Pier etal., the disclosure of which is hereby incorporated by reference herein,discloses a resterilizable surgical clip applier. The clip applieradvances and forms multiple clips during a single insertion into thebody cavity. This resterilizable clip applier is configured to receiveand cooperate with an interchangeable clip magazine so as to advance andform multiple clips during a single entry into a body cavity.

During endoscopic or laparoscopic procedures it may be desirable and/ornecessary to use different size surgical clips depending on theunderlying tissue or vessels to be ligated. In order to reduce overallcosts of a surgical clip applier, it is desirable for a single surgicalclip applier to be loadable with and capable of firing different sizesurgical clips as needed.

Accordingly, a need exists for endoscopic surgical clip appliers thatinclude reusable handle assemblies, reusable shaft assemblies, anddisposable clip cartridge assemblies, with each clip cartridge assemblybeing loaded with a particularly sized clip (e.g., small, medium, orlarge).

SUMMARY

According to an aspect of the present disclosure, a surgical clipapplier is provided and includes a handle assembly and an endoscopicassembly selectively connectable to a housing of the handle assembly.The handle assembly includes a housing; a trigger pivotally supported onand extending from the housing; and a drive assembly supported withinthe housing and operatively actuatable by the trigger. The driveassembly includes at least one linkage connected to the trigger, the atleast one linkage slidably supported in the housing; a guide blockslidably supported in the housing, the guide block operatively connectedto the trigger; a clip pusher bar slidably supported in the guide block,the clip pusher bar including a flange at a proximal end thereof; atoggle supported in the housing and located distal of the flange of theclip pusher bar, the toggle actuatable between a first position and asecond position, wherein the toggle is configured to limit the distaltranslation of the clip pusher bar when the toggle is in the firstposition; and a push rod supported in the housing, the push rodengageable by the at least one linkage to actuate the toggle between thefirst position and the second position. The endoscopic assembly includesa shaft assembly extending from the housing, the shaft assemblyincluding an outer tube; and a pair of jaws supported in and extendingfrom a distal end of the outer tube, wherein when the toggle of thehandle assembly in the second position, the pair of jaws are free toform a surgical clip on tissue.

The at least one linkage may include a first end and a second end, thefirst end of the linkage being pivotably connected to the trigger andthe second end of the linkage being pivotably connected to the guideblock such that actuation of the trigger translates the guide blockproximally.

The first end of the at least one linkage and the trigger may beslidably coupled to a slot defined in the housing such that uponactuation of the trigger, the first end of the at least one linkagerides along the slot.

In use, as the first end of the at least one linkage rides along theslot, the at least one linkage may exert a force on the push rod suchthat the push rod translates proximally to exert a force on the toggleto actuate the toggle from the first position to the second position.

The toggle may be spring loaded and may include a bias such that thetoggle abuts the flange in the first position.

In use, in the second position, there may be a clearance between thetoggle and the flange such that the clip pusher bar is able to translatedistally to locate the flange distal to the toggle.

The drive assembly may further include a biasing member acting on theclip pusher bar to urge the clip pusher bar in a distal direction.

In use, a force exerted by the bias of the toggle may be greater than aforce exerted by the biasing member acting on the clip pusher bar suchthat the biasing member is unable to push the flange past the togglewhen the toggle is in the first position.

The drive assembly may further include a trigger return spring acting onthe trigger to urge the trigger to an unactuated position.

In use, in the second position, the biasing member may act on the clippusher bar to urge the clip pusher bar distally until the flange thereofabuts the guide block.

In use, when the trigger is actuated, the at least one linkage maysimultaneously engage the push rod and the guide block such that thetoggle is in the second position and the guide block drives the abuttingflange proximally past the toggle.

According to another aspect of the present disclosure, a surgical clipapplier is provided and includes a handle assembly and an endoscopicassembly selectively connectable to a housing of the handle assembly.The handle assembly includes a housing; a trigger pivotally supported onand extending from the housing; and a drive assembly supported withinthe housing and operatively actuatable by the trigger. The driveassembly includes a distal linkage slidably supported in the housing,the distal linkage including a first end and a second end, the secondend of the distal linkage connected to the trigger; a proximal linkageslidably supported in the housing, the proximal linkage including afirst end and a second end, the first end of the proximal linkageconnected to the trigger; a jaw pusher slidably supported in thehousing, the jaw pusher operatively connected to the trigger; a guideblock slidably supported in the housing, the guide block operativelyconnected to the trigger; a clip pusher bar slidably supported in theguide block, the clip pusher bar including a flange at a proximal endthereof; a toggle supported in the housing and located distal of theflange of the clip pusher bar, the toggle actuatable between a firstposition and a second position, wherein the toggle is configured tolimit the distal translation of the clip pusher bar when the toggle isin the first position; and a push rod supported in the housing, the pushrod engageable by at least one of the proximal linkage and the distallinkage to actuate the toggle between the first position and the secondposition.

The endoscopic assembly includes a shaft assembly extending from thehousing, the shaft assembly including an outer tube; and a pair of jawssupported in and extending from a distal end of the outer tube, whereinwhen the toggle of the handle assembly in the second position, the pairof jaws are free to form a surgical clip on tissue.

In some embodiments, the distal linkage, the proximal linkage, and thetrigger are slidably coupled to a slot defined in the housing such thatupon actuation of the trigger, the distal linkage, the proximal linkage,and the trigger ride along a channel defined within the slot.

In use, actuation of the trigger may translate the jaw pusher distallyand translates the guide block proximally.

In use, as the proximal linkage rides along the slot, the proximallinkage may exert a force on the push rod such that the push rodtranslates proximally to exert a force on the toggle to actuate thetoggle from the first position to the second position.

According to another aspect of the present disclosure, a drive mechanismfor a surgical clip applier is provided and includes a clip pusher barand a toggle. The clip pusher bar includes a flange at a proximal endthereof and is configured for distal translation to advance a surgicalclip.

In some embodiments, the drive mechanism further includes a linkage anda push rod engageable by the linkage to actuate the toggle between thefirst position and the second position.

The drive mechanism may further include a housing. The clip pusher bar,toggle, linkage, and push rod may all be positioned within the housing.

The drive mechanism may further include a trigger pivotally supported onand extending from the housing, and with the linkage connected to thetrigger.

BRIEF DESCRIPTION OF THE DRAWINGS

A particular embodiment of a surgical clip applier is disclosed hereinwith reference to the drawings wherein:

FIG. 1 is a perspective view of a reposable endoscopic surgical clipapplier, according to the present disclosure;

FIG. 2 is an enlarged view of the indicated area of detail of FIG. 1;

FIG. 3 is a side, elevational view of a handle assembly of the surgicalclip applier of FIG. 1, with a housing half-section removed therefrom;

FIG. 4 is an enlarged, perspective view of a drive assembly of thehandle assembly of FIG. 3;

FIGS. 5A-5E are schematic elevational views of the drive assemblyillustrated in FIGS. 3 and 4, illustrating an actuation of a trigger ofthe surgical clip applier;

FIG. 6 is a perspective view of the clip cartridge tray of the surgicalclip applier illustrating the plurality of surgical clips loadedtherein; and

FIG. 7 is a perspective view of a surgical clip formed on a vessel.

DETAILED DESCRIPTION OF EMBODIMENTS

Embodiments of reposable endoscopic surgical clip appliers, inaccordance with the present disclosure, will now be described in detailwith reference to the drawing figures wherein like reference numeralsidentify similar or identical structural elements. As shown in thedrawings and described throughout the following description, as istraditional when referring to relative positioning on a surgicalinstrument, the term “proximal” refers to the end of the apparatus whichis closer to the user and the term “distal” refers to the end of theapparatus which is further away from the user.

Referring now to FIGS. 1-6, an endoscopic surgical clip applier inaccordance with an embodiment of the present disclosure is generallydesignated as 10. Surgical clip applier 10 generally includes a handleassembly 100, an endoscopic assembly 200 including a shaft assembly 210extending distally from handle assembly 100; and at least one surgicalclip cartridge assembly 300 selectively loadable into shaft assembly 210of endoscopic assembly 200. In embodiments, it is contemplated thatshaft 210 may be integrally formed with handle assembly 100. Inalternative embodiments, it is contemplated that shaft 210 may beselectively connectable to handle assembly 100.

Briefly, shaft assembly 210 of endoscopic assembly 200 may have variousouter diameters such as, for example, about 5 mm or about 10 mm,depending on intended use. Further, shaft assembly 210 may have variousrelatively elongated or shortened lengths depending on intended use,such as, for example, in bariatric surgery. In one embodiment, inbariatric surgery, shaft assembly 210 may have a length of between about30 cm and about 40 cm. However one skilled in the art should appreciatethat shaft assembly 210 may have any suitable length and the presentdisclosure is not limited to any of the above identified lengths.

In accordance with the present disclosure, each surgical clip cartridgeassembly 300 may be loaded with a plurality of surgical clips “C” (seeFIG. 6). The plurality of surgical clips “C” may be particularly sized(e.g., small surgical clips, medium surgical clips, or large surgicalclips). Each surgical clip cartridge assembly 300 is configured to beselectively loaded into shaft assembly 210 of endoscopic assembly 200,and to be actuated by handle assembly 100 to fire and form the pluralityof surgical clips “C” loaded therein onto underlying tissue and/orvessels “V” (see FIG. 7).

Referring now to FIGS. 1 and 3, handle assembly 100 of surgical clipapplier 10 is shown. Handle assembly 100 includes a housing 102 having afirst or right side half-section 102 a and a second or left sidehalf-section 102 b. Handle assembly 100 includes a trigger 104 pivotablysupported between right side half-section 102 a and left sidehalf-section 102 b of housing 102. Trigger 104 is biased by a triggerreturn spring 104 a (e.g., a spring) to an un-actuated condition.

Housing 102 of handle assembly 100 may be formed of a suitable plasticor thermoplastic material. Handle assembly 100 includes a removablecover 106 or the like which provides access to a drive assembly 120 ofclip applier 10. Housing 102 of handle assembly 100 further includes, asseen in FIG. 3, a nose 102 c defining an annular flange 102 d.

Handle assembly 100 includes a drive assembly 120 operatively connectedto trigger 104. Specifically, drive assembly 120 includes a proximallinkage 122, and a distal linkage 124. Though it is not shown in thefigures, it is contemplated that in some embodiments, there may be apair of proximal linkages 122 and a pair of distal linkages 124.Proximal linkage 122 includes a distal coupling portion 122 a pivotallyconnected to trigger 104, and a proximal coupling portion 122 bpivotally connected to a guide block 130. As shown in FIG. 4, guideblock 130 defines a longitudinally extending passage 130 a therethrough.

Distal linkage 124 includes a distal coupling portion 124 a pivotallyconnected to a jaw pusher 146, and a proximal coupling portion 124 bpivotally connected to trigger 104. A pin 126 pivotally connectsproximal linkage 122 and distal linkage 124 to trigger 104. Pin 126 isalso slidably disposed within opposed arcuate channels or slots 102 cformed in opposed handle half-sections 102 a, 102 b. In this manner, astrigger 104 is actuated, pin 126 rides along opposed arcuate channels102 c (see FIGS. 3-5E), and causes opposed proximal coupling portion 122b of proximal linkage 122 and distal coupling portion 124 a of distallinkage 124 to separate from one another.

Drive assembly 120 further includes a push rod 132 having a distal end132 a and a proximal end 132 b and supported within a push rod channel132 c defined in housing 102. Push rod 132 is configured to translatelongitudinally within push rod channel 132 c and engage a toggle 134.Toggle 134 is spring loaded with a bias for clockwise rotation (orrotation in a first direction) about a pivot point 134 a. As will bediscussed in further detail below, as trigger 104 is actuated, proximallinkage 122 exerts a force on push rod 132 driving push rod 132 in aproximal direction. Push rod 132 in turn exerts a force on toggle 134causing toggle 134 to rotate counter-clockwise (e.g., in a seconddirection opposite the first direction) about pivot point 134 a. Asshown in FIGS. 3-5E, push rod 132 includes a length “A.” It iscontemplated that length “A” of push rod 132 is configured to controlthe distance that push rod 132 has to travel prior to engaging toggle134 and may be chosen accordingly.

Wth continued reference to FIGS. 3-5E, drive assembly 120 includes aclip pusher bar 140 slidably supported within and through housing 102 ofhandle assembly 100. Clip pusher bar 140 includes a flange 142 asupported on a proximal end 140 a thereof, and a clip pusher couplingtip (not shown) formed at a distal end 140 b thereof. Flange 142 a has adiameter “D” such that flange 142 a abuts toggle 134 in the startingposition. Accordingly, distal translation of clip pusher bar 140 isprevented by toggle 134 when toggle 134 is in the starting positionshown in FIG. 3. Clip pusher bar 140 is dimensioned such that whentrigger 104 is actuated, clip pusher coupling tip projects from nose 102c of housing 102 of handle assembly 100.

A biasing member 144 (e.g., a compression spring) is interposed betweenhousing 102 of handle assembly 100 and flange 142 a of clip pusher bar140. Biasing member 144 acts on clip pusher bar 140 to bias or urge clippusher bar 140 in a distal direction. It is contemplated that theclockwise spring bias of toggle 134 produces a greater force than thedistal spring bias of biasing member 144. Accordingly, clip pusher bar140 is unable to translate distally past toggle 134 when trigger 104 isnot actuated.

Drive assembly 120 further includes a jaw pusher 146 slidably supportedwithin housing 102 of handle assembly 100. Jaw pusher 146 includes aproximal end 146 a pivotally connected to distal coupling portion 124 aof distal linkage 124, and a jaw pusher coupling tip 146 c formed at adistal end 146 b thereof. Jaw pusher 146 defines a lumen 146 dtherethrough for receipt of and slidable passage of clip pusher bar 140therein. Jaw pusher 146 is dimensioned such that jaw pusher coupling tip146 c thereof projects from nose 102 c of housing 102 of handle assembly100.

Wth continued reference to FIGS. 1-4, and with additional specificreference to FIGS. 5A-7, a firing stroke of surgical clip applier 10 isshown and described below. With surgical clip cartridge assembly 300loaded in endoscopic assembly 200, as trigger 104 of handle assembly 100is actuated to a fully actuated position, a distal-most clip “C1” of theplurality of surgical clips “C” is loaded into and formed by a pair ofjaws 214 of endoscopic assembly 200.

In particular, FIG. 5A illustrates drive assembly 120 prior to actuationof trigger 104 and FIGS. 5B-5E details the incremental actuation ofdrive assembly 120 as surgical clip applier 10 is fired. As trigger 104is actuated in the direction of arrow “E (see FIG. 3),” trigger 104 actson proximal linkage 122 to move proximal coupling portion 122 b ofproximal linkage 122 in a proximal direction (as indicated by arrow “F”of FIG. 3), and acts on distal linkage 124 to move distal couplingportion 124 a of distal linkage 124 in a distal direction (as indicatedby arrow “G” of FIG. 3). Further, distal coupling portion 122 a ofproximal linkage 122 and proximal coupling portion 124 b of distallinkage 124 are moved along opposed arcuate channels 102 c in thedirection indicated by arrow “H.”

As proximal coupling portion 122 b is moved in the direction of arrow“F,” proximal linkage 122 engages distal end 132 a of push rod 132. Inturn, push rod 132 translates along push rod channel 132 c to exert arotation force on toggle 134 in a counter-clock wise (e.g., second)direction. As shown in FIG. 5B, the counter-clock wise rotation oftoggle 134 creates a clearance “I” which is sufficient for flange 142 ato clear toggle 134 thereby allowing biasing member 144 to expand anddrive clip pusher bar 140 distally until flange 142 a of clip pusher bar140 abuts against guide block 130.

As clip pusher bar 140 of handle assembly 100 is moved in a distaldirection, clip pusher bar 140 engages endoscopic assembly 200, which inturn, acts on cartridge assembly 300 to load the distal-most surgicalclip “C1” into the pair of jaws 214.

Once flange 142 a of clip pusher bar 140 is abutting guide block 130 andas trigger 104 is actuated further in the direction given by arrow “E,”proximal linkage 122 continues to move guide block 130 in a proximaldirection, and guide block 130 acts on flange 142 a of clip pusher bar140 to urge clip pusher bar 140 in a proximal direction. Simultaneously,as shown in FIG. 5C, proximal linkage 122 maintains contact with distalend 132 a of push rod 132 such that push rod 132 maintains contact withtoggle 134. This in turn maintains clearance “I” between toggle 134 andflange 142 a such that guide block 130 is able to urge clip pusher bar140 proximally until flange 142 a clears toggle 134 (see FIG. 5D) and islocated proximal to toggle 134.

As clip pusher bar 140 is moved in a proximal direction, clip pusher bar140 engages endoscopic assembly 200, which in turn engages surgical clipcartridge assembly 300 to urge the remaining plurality of surgical clips“C” in a proximal direction. Surgical clip cartridge assembly 300proximally retracts the remaining plurality of surgical clips “C” untileach remaining clip of the plurality of surgical clips “C” is retracted.

As mentioned above, the actuation of trigger 104 in the direction ofarrow “E,” also acts on distal linkage 124 to move distal couplingportion 124 a of distal linkage 124 in a distal direction (as indicatedby arrow “G” of FIG. 3). As distal coupling portion 124 a of distallinkage 124 is moved in a distal direction, distal coupling portion 124a urges jaw pusher 146 in a distal direction. With jaw pusher 146connected to endoscopic assembly 200, as jaw pusher 146 is moved in thedistal direction indicated by arrow “G,” the pair of jaws 214approximate to the closed position.

Wth the distal-most surgical clip “Cl” loaded in the pair of jaws 214,as the pair of jaws 214 approximate to the closed position, distal-mostsurgical clip “C1” is formed therebetween, for example, on a vessel “V”or the like, as shown in FIG. 7.

With distal-most surgical clip “C1” formed, trigger 104 may be releasedand returned to an unactuated position either by or with the assistanceof trigger return spring 104 a (see FIG. 3). As trigger 104 is returnedto an unactuated position, trigger 104 acts on proximal linkage 122 tomove guide block 130 in a distal direction, and acts on distal linkage124 to move jaw pusher 146 in a proximal direction.

In particular, as shown in FIG. 5E, when trigger 104 is released, distalcoupling portion 122 a and proximal coupling portion 124 b move alongopposed arcuate channels 102 c in the direction indicated by arrow “J.”Simultaneously, proximal coupling portion 122 b moves distally in thedirection indicated by arrow “L” and distal coupling portion 124 a movesproximally in the direction indicated by arrow “M.” As distal couplingportion 122 a moves in the direction indicated by arrow “J” and proximalcoupling portion 122 b moves in the direction indicated by arrow “L,”proximal linkage 122 loses contact with distal end 132 a of push rod132. As a result, the bias of toggle 134 rotates toggle 134 clockwise toreturn toggle 134 to its starting position and exerts a force on pushrod 132 in the direction indicated by “K.” At this stage, clearance “I”between toggle 134 and flange 142 a no longer exists. Accordingly,flange 142 a of clip pusher 140 is unable to advance distally pasttoggle 134, thereby resetting clip applier 10 for another firing.

In use, surgical clip applier 10, as mentioned above, is capable ofloading different surgical clip cartridge assemblies 300 in endoscopicassembly 200. Specifically, endoscopic assembly 200 may be loaded with asurgical clip cartridge assembly 300 that is loaded with the pluralityof surgical clips “C” having a first size, or endoscopic assembly 200may be loaded with a surgical clip cartridge assembly 300 that is loadedwith the plurality of surgical clips “C” having a second size differentthan the first size.

In this manner, the user or surgeon may load a surgical clip cartridgeassembly 300, loaded with a particular size of surgical clips, dependingon the particular surgical procedure to be performed. Additionally,during a surgical procedure, if the need arises to use a different sizedsurgical clip, the user or surgeon may eject or unload the surgical clipcartridge assembly 300 that is loaded in endoscopic assembly 200 andthen load a new surgical clip cartridge assembly 300 (having a differentsized plurality of surgical clips loaded therein as compared to theunloaded surgical clip cartridge assembly 300) into endoscopic assembly200.

In accordance with the present disclosure, it is contemplated thatsurgical clip applier 10 includes a reusable and sterilizable handleassembly 100 that may be used for multiple surgical procedures; areusable and sterilizable endoscopic assembly 200 that may also be usedfor multiple surgical procedures; and a disposable, single use clipcartridge assembly 300 (e.g., wherein the clip cartridge assembly 300 isdisposed of when unloaded from endoscopic assembly 200). It iscontemplated that endoscopic assembly 200 may be disposed of followingthe particular surgical procedure and not reused or sterilized.

Also in accordance with the present disclosure, it is furthercontemplated that a surgical kit may be provided including a singlehandle assembly 100, a single endoscopic assembly 200, and a pluralityof clip cartridge assemblies 300 including at least a first set of clipcartridge assemblies loaded with a plurality of surgical clips having afirst size and a second set of clip cartridge assemblies loaded with aplurality of surgical clips having a second size different than thefirst size. The kit may include instructions for the assembly orsurgical clip applier 10, the use of surgical clip applier 10, and theprocessing of surgical clip applier assembly 10 following use.

It should be understood that the foregoing description is onlyillustrative of the present disclosure. Various alternatives andmodifications can be devised by those skilled in the art withoutdeparting from the disclosure. Accordingly, the present disclosure isintended to embrace all such alternatives, modifications and variances.The embodiments described with reference to the attached drawing figuresare presented only to demonstrate certain examples of the disclosure.Other elements, steps, methods and techniques that are insubstantiallydifferent from those described above and/or in the appended claims arealso intended to be within the scope of the disclosure.

What is claimed is:
 1. A surgical clip applier, comprising: a handleassembly including: a housing; a trigger pivotally supported on andextending from the housing; and a drive assembly supported within thehousing and operatively actuatable by the trigger, the drive assemblyincluding: at least one linkage connected to the trigger, the at leastone linkage slidably supported in the housing; a guide block slidablysupported in the housing, the guide block operatively connected to thetrigger; a clip pusher bar slidably supported in the guide block, theclip pusher bar including a flange at a proximal end thereof andconfigured for distal translation to advance a surgical clip; a toggledistal of the flange of the clip pusher bar, the toggle actuatablebetween a first position and a second position and configured to limitthe distal translation of the clip pusher bar when the toggle is in thefirst position; and a push rod supported in the housing, the push rodengageable by the at least one linkage to actuate the toggle between thefirst position and the second position; and an endoscopic assemblyextending distally from the housing of the handle assembly, theendoscopic assembly including: a shaft assembly extending from thehousing, the shaft assembly including an outer tube; and a pair of jawssupported in and extending from a distal end of the outer tube, whereinwhen the toggle of the handle assembly in the second position, the pairof jaws are free to form the surgical clip on tissue.
 2. The surgicalclip applier according to claim 1, wherein the at least one linkageincludes a first end and a second end, the first end of the linkagebeing pivotably connected to the trigger and the second end of thelinkage being pivotably connected to the guide block such that actuationof the trigger translates the guide block proximally.
 3. The surgicalclip applier according to claim 2, wherein the first end of the at leastone linkage and the trigger are slidably coupled to a slot defined inthe housing such that upon actuation of the trigger, the first end ofthe at least one linkage rides along the slot.
 4. The surgical clipapplier according to claim 3, wherein as the first end of the at leastone linkage rides along the slot, the at least one linkage exerts aforce on the push rod such that the push rod translates proximally toexert a force on the toggle to actuate the toggle from the firstposition to the second position.
 5. The surgical clip applier accordingto claim 1, wherein the toggle is spring loaded and includes a bias suchthat the toggle abuts the flange in the first position.
 6. The surgicalclip applier according to claim 1, wherein in the second position, thereis a clearance between the toggle and the flange such that the clippusher bar is able to translate distally to locate the flange distal tothe toggle.
 7. The surgical clip applier according to claim 5, whereinthe drive assembly further includes a biasing member acting on the clippusher bar to urge the clip pusher bar in a distal direction.
 8. Thesurgical clip applier according to claim 7, wherein a force exerted bythe bias of the toggle is greater than a force exerted by the biasingmember acting on the clip pusher bar such that the biasing member isunable to push the flange past the toggle when the toggle is in thefirst position.
 9. The surgical clip applier according to claim 1,wherein the drive assembly further includes a trigger return springacting on the trigger to urge the trigger to an unactuated position. 10.The surgical clip applier according to claim 8, wherein in the secondposition, the biasing member acts on the clip pusher bar to urge theclip pusher bar distally until the flange thereof abuts the guide block.11. The surgical clip applier according to claim 8, wherein when thetrigger is actuated, the at least one linkage simultaneously engages thepush rod and the guide block such that the toggle is in the secondposition and the guide block drives the abutting flange proximally pastthe toggle.
 12. A surgical clip applier, comprising: a handle assemblyincluding: a housing; a trigger pivotally supported on and extendingfrom the housing; and a drive assembly supported within the housing andoperatively actuatable by the trigger, the drive assembly including: adistal linkage slidably supported in the housing, the distal linkageincluding a first end and a second end, the second end of the distallinkage connected to the trigger; a proximal linkage slidably supportedin the housing, the proximal linkage including a first end and a secondend, the first end of the proximal linkage connected to the trigger; ajaw pusher slidably supported in the housing, the jaw pusher operativelyconnected to the trigger; a guide block slidably supported in thehousing, the guide block operatively connected to the trigger; a clippusher bar including a flange at a proximal end thereof and configuredfor distal translation to advance a surgical clip; a toggle distal ofthe flange of the clip pusher bar, the toggle actuatable between a firstposition and a second position and configured to limit the distaltranslation of the clip pusher bar when the toggle is in the firstposition; and a push rod supported in the housing, the push rodengageable by at least one of the proximal linkage and the distallinkage to actuate the toggle between the first position and the secondposition; and an endoscopic assembly extending distally from the housingof the handle assembly, the endoscopic assembly including: a shaftassembly extending from the housing, the shaft assembly including anouter tube; and a pair of jaws supported in and extending from a distalend of the outer tube, wherein when the toggle of the handle assembly inthe second position, the pair of jaws are free to form a surgical clipon tissue.
 13. The surgical clip applier according to claim 12, whereinthe distal linkage, the proximal linkage, and the trigger are slidablycoupled to a slot defined in the housing such that upon actuation of thetrigger, the distal linkage, the proximal linkage, and the trigger ridealong a channel defined within the slot.
 14. The surgical clip applieraccording to claim 12, wherein actuation of the trigger translates thejaw pusher distally and translates the guide block proximally.
 15. Thesurgical clip applier according to claim 12, wherein as the proximallinkage rides along the slot, the proximal linkage exerts a force on thepush rod such that the push rod translates proximally to exert a forceon the toggle to actuate the toggle from the first position to thesecond position.
 16. The surgical clip applier according to claim 12,wherein the toggle is spring loaded and includes a bias such that thetoggle abuts the flange in the first position.
 17. The surgical clipapplier according to claim 12, wherein in the second position, there isa clearance between the toggle and the flange such that the clip pusherbar is able to translate distally to locate the flange distal to thetoggle.
 18. The surgical clip applier according to claim 16, wherein thedrive assembly further includes a biasing member acting on the clippusher bar to urge the clip pusher bar in a distal direction.
 19. Thesurgical clip applier according to claim 18, wherein a force exerted bythe bias of the toggle is greater than a force exerted by the biasingmember acting on the clip pusher bar such that the biasing member isunable to push the flange past the toggle when the toggle is in thefirst position.
 20. The surgical clip applier according to claim 12,wherein the drive assembly further includes a trigger return springacting on the trigger to urge the trigger to an unactuated position. 21.The surgical clip applier according to claim 18, wherein in the secondposition, the biasing member acts on the clip pusher bar to urge theclip pusher bar distally until the flange thereof abuts the guide block.22. The surgical clip applier according to claim 21, wherein when thetrigger is actuated, the proximal linkage simultaneously engages thepush rod and the guide block such that the toggle is in the secondposition and the guide block drives the abutting flange proximally pastthe toggle.
 23. A drive mechanism for a surgical clip applier,comprising: a clip pusher bar including a flange at a proximal endthereof and configured for distal translation to advance a surgicalclip; and a toggle distal of the flange of the clip pusher bar, thetoggle actuatable between a first position and a second position andconfigured to limit the distal translation of the clip pusher bar whenthe toggle is in the first position.
 24. The drive mechanism for asurgical clip applier of claim 23 further comprising a linkage and apush rod engageable by the linkage to actuate the toggle between thefirst position and the second position.
 25. The drive mechanism for asurgical clip applier of claim 24 further comprising a housing, the clippusher bar, toggle, linkage and push rod all positioned within thehousing.
 26. The drive mechanism for a surgical clip applier of claim 25further comprising a trigger pivotally supported on and extending fromthe housing, the linkage connected to the trigger.